IT ’ S ALL ABOUT TRUST . WORKING WITH PEDIATRIC PATIENTS
It is our job to stress the importance of compliance and to get everyone on board with the pedorthic treatment prescribed by the physician .
contoured to limit the “ orthopedic ” appearance of the footwear . I also explained the sandal lift would be red and white to match the sandal . The physical therapist was also consulted as far as the rocker sole and adjusting it for Sarah ’ s line of progression . Everyone left the initial office visit satisfied . Upon delivery , both Sarah and her mother were very excited to see the results . This leads to the final part of the process — compliance .
Compliance is a huge part of the process . If the child refuses to wear the footwear or device ( s ), everyone loses . It is our job to stress the importance of compliance and to get everyone on board with the pedorthic treatment prescribed by the physician . If the pedorthic footwear or device ( s ) are “ cool ,” includes the patient ’ s favorite color or does not look “ Frankenstein-esque ,” then the chances of getting the patient to be compliant is greatly enhanced . I am glad to say Sarah was compliant , and I look forward to treating her for many years to come .
Pablo
My other recent patient , “ Pablo ,” was different . Pablo is an outgoing seven-year-old boy whose dad noticed he would often fall when running and described in his limited English a “ foot slap .” Pablo ’ s Doctor of Podiatric Medicine ( DPM ) sent not only a prescription but a full-page exam and diagnosis sheet . His DPM diagnosed him with Ligamentous Laxity , Leg Length Discrepancy ( LLD ) and Internal Tibial Torsion . The prescription called for a pair of University of California-Berkeley Laboratory ( UCBL ) foot orthotics and extra depth shoes .
Gaining Pablo ’ s trust was uncomplicated , and the assessment went smoothly after giving him a retractable tape measure to play with . His father was interested in everything that was done , and Pablo liked the idea of taking home an imprint of his foot ( one of the inked pressure mat sheets that I felt did not properly capture his foot ). Because I was going to have to take a mold of Pablo ’ s foot , I was going to have to employ another process left out in Sarah ’ s visit — demonstration .
Demonstration is important because even with a child who seems to be okay with everything you are doing , you never know when something will spook the child . If it does , you have to start all over again to regain their trust . For Pablo this meant being able to press his finger into the corner of the foam impression box before his feet were to go in . Through this demonstration of how it feels , I let him become comfortable with the process and included him in his treatment . I also allowed him to play with the pediatric Brannock device while taking the impression . This did two things : It allowed him to get comfortable with the device before I applied it to his feet , and it also distracted him while I was taking the impression of his feet so I did not get “ help .”
When Pablo came in for his orthotics , they were , as promised — his favorite color and a pair of white sneakers . Again , acceptance leads to compliance . Pablo and his father both had it explained to them in detail how the shoes and orthotics would help but that they only help if they are worn . I explained they may feel a little weird or feel like they push up in the arch but after getting used to them , it would go away .
The first follow-up visit revealed Pablo is semi-compliant . He is high energy and his mom told me at first he did not want to wear the shoes . Pablo ’ s parents had the good sense to keep on him to wear the shoes and orthotics . This is why it is so important to have the parents on board with the device ( s ) dispensed . Parents do not want their children to be uncomfortable and if the child is persistent , some parents will fold . The information they receive , though , will help them persevere in the healing process .
Summary
Keeping in mind there are a few tips that should help make the pediatric patient ’ s office visit faster , smoother and less stressful for all involved , including :
• Gain their trust ;
• Explain everything ;
• Demonstrate procedures before performing them ;
• Acceptance of the device ( s ) is crucial ; and
• Compliance by the patient and parent ( s ) is essential .
As a credentialed pedorthist who has had success with pediatric patients , I highly encourage you to educate yourself in this arena . When you are adequately armed with the knowledge and experience necessary , market to this population through referral sources . You ’ ll be doing your practice and your community a favor
22 Pedorthic Footcare Association www . pedorthics . org